The dependence between the volume of thrombotic lesions of branches pulmonary artery by CT-angiography and clinical symptoms, echocardiographic and electrocardiographic signs of pulmonary embolisms

The analysis of conditions of occurrence of electrocardiographic and echocardiographic symptoms of overload of right departments of heart in 256 patients with thromboembolism of branches pulmonary artery with different degree of stenosis of the main, lobar, or segmental vessels. It was found that the significant for the occurrence of clinical, electrocardiographic and echocardiographic symptoms of overload of the right heart is the narrowing of more than 50% of the lumen of the pulmonary artery at any level. At the same time, the larger the artery, the less degree of stenosis is necessary for the occurrence of electrocardiographic, echocardiographic and clinical signs of pulmonary embolism. Thus, in patients with 50-90% thrombotic stenosis of the lumen of the main pulmonary artery, significant signs of overload of the right ventricle were established. A more extensive degree of obturation in such patients, with a high probability, is associated with high mortality. In patients with the level of lesions of the lobar arteries, the most significant is the degree of obturation from 90% to 100% of the vessel lumen. In patients with segmental lesions, the appearance of signs of overload of the right heart depends not on the degree of intravascular obstruction, but on the number of affected arteries.